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THE COMMONWEALTH OF MASSACHUSETTS Entered incom uteri
PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01ppf Cation for his 08al bpstem C�ConstrULtion 3pPrmit
Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address K Lot No. 3 2 v-a 1 law k� _ Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel 1_1 06 _ S LI �roar e
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms @ Lot Size sq.ft. Garbage Grinder( )
Other Type of Building t Cy(c3 N.,3'`L e f No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 :3 C2 gpd Design flow provided ?2�j`'�,�j gpd
Plan Date 'S=Cs —l 1 Number of sheets 'y Revision Date
Title
Size of Septic Tank fy ls*'In s Type of S.A.S. LC, 6 C V1C M��E'f S I A-)���S j(0
Description of Soil
Nature of Repairs or/Alterations(A`nsw1er_when applicable) \N \ 6 ,jr � i _ LC.(4y
tQNc� C,_S `7\ o1 _04 MNl 1fJ\C;✓��
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signe Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued //
t
�rY. n, TT• _�x: r�`•!� tw., s�.. , , . .n_ -�*M a�teF. M ^.
a IL/60
j
No. , Fee I
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
' PUBLIC HEALTH DIVISION��T0�14+N OF BARNSTABLE, MASSACHUSETTS Ye;
ftplitation for I8 "a' 6pBtem Construction Permit
Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.3 W i tc,n3 'bwner's Name,Address,and Tel.No.
Assessor's Map/Parcel ::k pg S'C( C(OC`C P
8
4 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms ''> Lot Size Igloo q.,ft. Garbage Grinder( )
Other Type of Building C es cc� t A I No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 1 gpd Design flow provided '��j' 3, �{ gpd
Plan Date G- ) �' Number of sheets 2 Revision Date
Title
Size of Septic Tank F X tattNm, Type of S.A.S. ___L�, G C ti1t.M�E(S t c�1''�t'►� jl�l�'
Description of Soil, r '
Nature of Repairs or Alterations(Answer when applicable) !I nJ O c J C - �-�-•�O
`nrrvAbr(S Sjf0NC cis S\awN r,yo
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed Date
Application Approved by Date �J
Application Disapproved by Date
for the following reasons
Permit No. MpDate Issued ��
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( "� Upgraded( )
Abandoned( )by k o"1 G S A \`"]((ti�,�1
at :. W�,} ,� `�( C�-n�4c� t 1 i has been constructed in accordance
t7 L,
with the provisions of Title h f � ``
p s e 5 and the or Disposal System Construction Permit No: 7 io dated
Installer`��> G a A (C�_Or� 'S NC Designer�Sn16�✓�N 6
#bedrooms 3 Approved design flow 3 iy _ gpd
The issuance of this permit shall not be construed as a guarantee that the system will functf on dgned.
Date 1'7 Inspector
No. l2 Fee /1�70)
THE COMMONWEALTH OF MASSACHUSETTS T—
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
-Misposal 6pstr `Onstruction Permit
Permission is hereby granted to Construct( ) Repair(t4 Upgrade( Abandon( )
System located at t.✓r I-G ^J V t 1 d f C rl'AC/V/l�c
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be comp/lleete((witithhin three years of the date of this Cby
. .------------..,
Date '�j///J ! Approved
Town of Barnstable
,Regulatory Services
Richard V. Scali Interim Director
* BARNSTABLE,
MASS. Public Health Division
1639. ♦�
Thomas McKean; Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
f
Installer& Designer Certification Form.
Date: -7 1 7 10 Sewage Permit# ,R01`*7• N& Assessor's Map\Parcel �✓'
Designer: ng;ree��in� Wa►-its, Ind:. Installer: }� n'lS (b •k1y, C.,
Address: JZ W, RJ_. ._ Address: �• (� C1,dY ((-
s k-atu le` iMiA 6 26 y Le✓i � I i M 14-
11
On S I ! :-1"7 1�• � ���>vy� was issued:a permit to install a
(date) rr __(installller)
septic system at 2- 01�.7�A� Y✓; CJVV1t/'Aa`sed on a design drawn by.
(address)
1
�eler i. �M LG�►+�e T L I
G I Cne_r eL9 (a1t>A u dated ( -
(designer)
I certify that the septic system referenced above.was installed substantially according to
the.design, which may include minor approved changesl,such as lateral relocation of the
distribution box and/or.septic tank. Strip out (if requi#ed) was inspected and the soils
were found satisfactory.
s
I certify that the septic system referenced above was installed with major changes (i,c.
greater'than 10' lateral relocation.of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State &.Local .Regulations. Plan revision or
certified as-built by designer to follow. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the system referenced above was construct�e rice with the terms
of the IAA approval letters(if applicable) .++OF
PETE T.R ; r
i McENTEE � ;
CML
(Ins 's Signature)' ►�•35109
TER��
( esigner s Signature) (Affix De'signer tamp Here).
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
QASeptic0csigner Ccrtification Form Rev 8-14-13.doc
l
TOWN OF BARNSTABLE
LOCATION W kt,.3 A4— SEWAGE# -7
<� VILLAGECPN roll Ix ASSESSOR'S MAP&7PARCEL
INSTALLER'S NAME&PHONE NO. J%Dp,�<%I, N 1.7 Q r/JC.-
SEPTIC TANK CAPACITY e')Q(S7�Jey
LEACHING FACILITY:(type) e—G Co CIAG*6 c�P�_ (size) fi e,, fJ 0C,61
NO.OF BEDROOMS
OWNER COeL
PERMIT DATE: -jI —17 COMPLIANCE DATE:
Separation Distance Between the: (y�� ANC®IYV�'IWL�
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
1 39 'Dr
Our ^ 41 2 c
D 10
-1 ® .
iv'
3�lOGq
I
Town of Barnstable P# - 15 5 0`2
Department of Regulatory Services
` Public
sr�8 Health Division Date — r
�A t639 ,b� 200 Main Street,Hyannis MA 02601
lg0 FAA A
XA l s •
Date Scheduled "/ � �� Time /� Fee Pd, "' t
Soil Suitability Assessment for S ge Dis teal
Peifiormed By: 'O -G a't1-� 13 J >
Witnessed
LOCATION & GENERAL INFORMATION
Location Address -� q��0 Jet_®� ��0� Owner's Name ��,r,yk� ����q?�-
Address,
Assessor's Map/Parcel: ',-s_. Engineer's Name � 3 p�.
NEW CONSTRUCTION REPAIR - ( Telephone# C% 1'o q"7
Land Use ``t 5 i<- ;� E _ Slopes,(IYO) ( 1_ Surface Stones ;\ ' /A _
Distances from: Open Water Body _ft Poss(ble Wet Area 1 - ft Drinking Water Well "'l--S ft
Drainage Way ft Property Line i ft Other
----f t
i
SKETCH: (Street name,dimensions of lot,exact locati Ins of test holes&pere tests,locate wetlands fn proximity to holes)
i i it
1
0
_- -- ----
. ' f i � 2
Parent material(geologic) �J =
( Depth to Bedrock
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Race
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH 'WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in, Depth to sail mottles:_,e ..-.in.
Depth to weeping from side of obs.hole: -v(n, Ground water AdJustment
Index Well# Reading Date: Index Well level,. e Adj,factor,•,,,,. A0j,Groundwater Ural
PERCOLATION TEST Wtv—
Observation
Hole# I Time at 4"
Y--sue I -.m�.+..•�.wr+. -..+v�.n.v.e.
Depth of Perc I Time at 6"
Start Pre-soak Time _ Sr l^ Time(9"•6")
End Pre-soak
Rate Min.flnch. -L
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)—
I
Original: Public Health Division Observation Hole Data To Be Completed on Back-----•-----
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least ong (1) week prior to beginning.
Q:\SEPTICVERCFORM,DOC / �n
i
I
• f
DEEP.OBSERVATION HOLE LOG Hole# 1
Depth from Soil Horizon Soil Texture S(dil Color Soil
' Other
Surface(in.) (USDA) i(Munsell) Mottling '(Structure,Stones;Boulders,
nsistency,% ravel
.�
DEEP OBSERVATION HOLE LOG Hole# .Z
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munseli) Mottling (Structure,Stones,Boulders.
Consistent g° rav i
?I 5—r G!G
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) l(Munseil) Mottling (Structure,Stones,Boulders,
Consistency,%Gravel)
i
i
I
_ v
DEEP OBSERVATION HOLE LOG. Hole#
Depth from Soil liorizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) i(Munsell) _Mottling (Structure,Stones,Boulders.
Consistency,°/o aravell
f
— I
Flood Insurance Rate Man:
Above 500 year flood boundary No— Yes .__
t
Within 500 year boundary No Yes _
Within 100 year flood boundary No— Yes
i
Depth of i�laturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? �S
If not, what is the depth of naturally occurring perviou's material?
Certification
) I have passed PP Y
I certify that on assed�the soil evaluator examination approved b the
Department of Environmental Protection and that the (above analysis was performed by me consistent with
the required ing,expertise and experience described in a10 CMR 15.017.
%� _...__..._. .� Date ` r
Signature --�-- .�
I
f
Q:\4BP'rlaPLRCFORM.DOC
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is required for CENTERVILLE MA 02632 7/15/09
every page. Citylrown State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important: A, General Information
When filling out
forms on the
computer,use 1. Inspector:
only the tab key
c move your DOUGLAS A. BROWN
use the return cursor- not Name of Inspector
key. DOUGLAS A. BROWN INC
Company Name
� P.O. BOX 145
Company Address
CENTERVILLE MA 02632
'dB Cityrrown State Zip Code
508-420-4534 S14297
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection.The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. t am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000).The system: t C
® Passes ❑ Conditionally Passes ❑ Fails m
"0 C ►
❑ Needs Further Evaluation by the Local Approving Authority ►v w
V11
to
8/21/09 SRI
ns�on�ature Date W
The system inspector shall submit a copy of this inspection report to the Approving Authority(EFoard r1'1
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.(This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
t
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
g 32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is CENTERVILLE required for MA 02632 7/15/09
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® 1 have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
SYSTEM MEETS MINIMUM PASSING REQUIREMENTS AT THIS TIME
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired.The system, upon completion of the replacement or repair, as approved by
the Board of Health,will pass.
Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not
determined,"please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is
structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System
will pass inspection if the existing tank is replaced with a complying septic tank as approved by the
Board of Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND(Explain below):
t5ins•09M Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
'( 32 WILTON DR
Properly Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is required for CENTERVILLE MA 02632 7/15/09
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes(cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health,safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins•09/08
Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is CENTERVILLE
required for MA 02632 7l15/09
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health(and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform
bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be
attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes"or"No"to each of the following for all inspections:
Yes No
El ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less
than Y2 day flow
t5ins•09108 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 4 of 17
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is CENTERVILLE
required MA 02632 7/15l09
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required,pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply
well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303,therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems,you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area(interim Wellhead Protection
Area—IWPA)or a mapped Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,
or answered"yes"in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304.The system owner should contact the appropriate
regional office of the Department.
t5ins•09/08
Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
'Y 32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is required for CENTERVILLE MA 02632 7/15/09
every page. City/Town State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes"or"no"as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner,occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
❑ ® Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined?(If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid,depth of sludge and depth of scum?
❑ ® Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
❑ ❑ Determined in the field(if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms(design): 3 Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330
t5ins•09JD8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
'( 32 WILTON DR
Properly Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is CENTERVILLE required for MA 02632 7/15/09
every page. City/Town State Zip Code
Date of Inspection
D. System Information
Description:
ACCORDING TO AS BUILT CARD SYSTEM CONSISTS OF A 1500 GALLON TANK D-BOX AND 4
FLOW DIFFUSERS
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ❑ No
Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ❑ No.
Laundry system inspected? ❑ Yes ❑ No
Seasonal use?
❑ Yes ❑ No
Water meter readings, if available(last 2 years usage(gpd)):
Detail:
CALLED WATER DEPT THEY WERE UNABLE TO GIVE READINGS DUE TO TAMPERING WITH
WATER METER
Sump pump?
❑ Yes ❑ No
Last date of occupancy:
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203):
Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ms-09M - Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
'Y 32 WILTON DR
Properly Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is CENTERVILLE
required for MA 02632 7/15/09
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: B.O.H SHOWS LAST PUMPING IN 06
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped:
gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system(yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology.Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank.Attach a copy of the DEP approval.
❑ Other(describe):
t5ms-0908 Tille 5 Official Inspeclion Form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
'l 32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is required for CENTERVILLE MA 02632 7/15/09
every page. Cityrrown State . Zip Code Date of Inspection
D. System Information (cunt.)
Approximate age of all components, date installed(if known) and source of information:
1997 ACCORDING TO AS-BUILT
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade:
P
feet
Material of construction:
❑cast iron ❑40 PVC ❑other(explain):
Distance from private water supply well or suction line: feet
Comments(on condition of joints,venting, evidence of leakage, etc.):
Septic Tank(locate on site plan):
Depth below grade: feet
Material of construction:
❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
Sludge depth:
t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
TOWN OF BARNSTABLELOCATION SEWAGE#
VELLAGE Ca 1 g ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY a
LEACHING FACII.TTY: (type) size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: g- 1 COMPLIANCE DATE: 2--1 "/ 7
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist ,.J
within 300 feet of leaching facility) G — Feet
Furnished by
�4 "o c -
�{ ��Q �vss� �
� - c = 3t
� �
� = ���
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
't 32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is required for CENTERVILLE MA 02632 7/15/09
every page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle
Scum thickness
Distance from top of scum to top of outlet tee or baffle
60"ism
Distance from bottom of scum to bottom of outlet tee or baffle
How were dimensions determined?
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
HOUSE HAS BEEN VACANT FOR A WHILE LOOKS LIKE SYSTEM HAD HEAVY USE AT ONE
TIME BUT VERY LITTLE USE LATELY
Grease Trap(locate on site plan):
Depth below grade: feet
Material of construction:
❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins•09R18 Title 5 Official inspection Forth:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is CENTERVILLE required for MA 02632 7/15/09
every page. Cltyrrown State Zip Code
Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan):
Depth below grade:
Material of construction:
❑concrete ❑ metal ❑fiberglass ❑ polyethylene
❑ other(explain):
Dimensions:
Capacity:
gallons
Design Flow:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping:
Date
Comments(condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disp
osal posal System•Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is CENTERVILLE
required for MA 02632 7/15/09
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cunt.)
Distribution Box(if present must be opened)(locate on site plan):
Depth of liquid level above outlet invert
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
BOX LEVEL AT THIS TIME, SOME SOLID CARRY OVER
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
Soil Absorption System(SAS)(locate on site plan, excavation not required):
If SAS not located, explain why:
APPEARS TO BE DEEP I PROBED IN THE AREA AND FOUND NO RISERS
t5ins-09108
Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is CENTERVILLE required for MA 02632 7/15/09
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits. number:
❑ leaching chambers number:
® leaching galleries number: 4
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/altemative system
Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
COULD NOT DETERMINE LEVEL OF PONDING DUE TO DEPTH OF S.A.S , CAN NOT PREDICT
FUTURE PERFORMANCE OF LEACHING SYSTEM
Cesspools(cesspool must be pumped as part of inspection)(locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
t5ins•09/08
Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
'Y 32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is CENTERVILLE required for MA 02632
every page. City/Town State Zip Code Date of Date of 9
Inspection
D. System Information (cont.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins•09/08 Title 5 Official Insp
ection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is CENTERVILLE required for MA 02632 7/15/09
every page. -Eit-y-frown State Zip Code
Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
❑ hand-sketch in the area below
® drawing attached separately
Li
I•
t5ins•09/08
Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
'^ 32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information for
is CENTERVILLE
required MA 02632 7/15/09
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: 15
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health-explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
OFF AS-BUILT CARD#97-481
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•09/06
Title 5 Official inspection Form:Subsurface Sewage Disposal System.•Page 16 of 17
Commonwealth of Massachusetts
,p Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
32 WILTON DR
Property Address
GREENWICH INVESTORS XXVI,LLC
Owner Owner's Name
information is CENTERVILLE required for MA 02632
every page. City/Town Date/09
State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary:A, B, C, D, or E checked
® Inspection Summary D(System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•09M
Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
t
No. / O\ Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
application for 30i5po.5ar *pztem Conotruction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
c�T Address p t No. A _WOwner's Name,A ss and Tel.No.
Assessor's Map/Parcel L�
Installer' ame,Address,and Tel.No. Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No. of Bedrooms Lot Size sq. ft. Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow;XC9 gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title OR
Size of Septic Tank �d Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer hen applicab e) 0
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions It a the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issue this B and . Heal
Signed w Date ��T
Application Approved by C Date -
Application Disapproved for the t9lowinereasons
Permit No. Date Issued
No. Fee 7_11
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
ioizpooal bpotem Construction Verna
Permission is hereby granted to Cons ruct )Repair(Upgrade( )Aband n( )
System located at 0
and as described in the above Application for,Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
�;Date: Approved by .
No. * Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
2pprication for Mitpozaf *pgtem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
cation Add re s p t No. Owner's Name,A ss and Tel.No.
Assessor's Map/Parcel
Installer' ame,Address,and Tel.No. Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow �3� - gallons per day. Calculated daily flow gallons.
Plan Date r '� Number of sheets Revision Date
Title ;
Q OE
Size of Septic Tank 01
vneo
;
Description of Soil
Nature of R pairs or Alterations(Answer when applicab )
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions�fTit a of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issue&b. this Board Heal
Signed Date
Application Approved by Date
Application Disapproved for the fTowinPreasons i
it
t ,
Permit No. - Y611 Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of (Compliance
THIS IS TO CERTIFY, at the On-site Sewage Disposal System Constructed( )Repaired (Upgraded( )
Abandoned( )by /IU
at / has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 14 dated
Installer Designer x ,r
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
Date Inspector
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONS7'ItUC CON PERMIT(W1'r11OUT DESIGNED PLANS)
i, hereby certify that the application for disposal works
construction permit signed by me dated concerning� �- lG � � � ' g the
property located at � � ,�i� �ir/ eets all of the
following criteria:
• There are no wetlands within 300 feet of the proposed septic system
• There are no private wells within 150 feet of the proposed septic system
• The observed groundwater table is 14 feet or greater below the bottom of the leaching facility
• There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
SIGNED: DATE:
LICENSED TIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
(Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan,
this plan should be submitted).
. t
( -57c;, 6 ��
A� O
Ssa AS
i
TOWN OV BARNSTABLE
LOCATION w
2 SEWAGE # �•
ASSESSOR'S MAP &LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC.TANK CAPACITY
LEACHING FACILITY: (type)
NO:.&`BEDROOMS
BUILDER OR OWNER
PERMIT DATE: S S 7 COMPLIANCE DATE: 2 Z`Z
Separation Distance Between the: � Feet
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility
Private Water Supply Well and Leaching Facility (If any wells exist �y Feet
on site or within 200 feet of leaching facility)
Edge.of Vetland and Leaching Facility(If any wetlands exist Feet
within 300 feet of leaching facility)
Furnished by
H i
-CJ
1
i,
-100--EXISTING CONTOUR y N
t`
/ If x 100.98 EXISTING SPOT GRADE g
a . - LOCUS
�%I EXISTING WATER SERVICE �, a
0
OVERHEAD WIRES a a °'. s
EXISTING S.A.S. TEST PIT o 4, f
TO BE ABANDONED PB 1¢E�,o BENCHMARK o o�° c
EXISTING SEPTIC TANK c 23 �� LEGEND c.
TOP OF TANK, EL.=101.45,
INV.(OUI)=100.1f(VER/FY) +14-
-N-+7L�'a0"_W--_--112 N 18°26'30" W\
- -xo-- ---49 76'------ - 50.24-' ` I LOCUS MAP
t�G-""� � NOT TO SCALE
�M-2 -108 --- -----------�08 \\ �� X 1145',
TOP OF TANK
EL.=101.45
104.33
105.02 1G6-- x 106.771-- --"PROPOSED S.A.S. GENERAL NOTES:
10 - D� Ea �-
103,60 103. 4 R/ - 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
BOARD OF HEALTH AND THE DESIGN ENGINEER.
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
it 1 70 '`' `.•" 103.54:.";._• 'f 103-€3� --- OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
� w I ' O O O LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW:
0 5-7 '' ' O :`I --STRIPOUT BOUNDARY -310 CMR 15.405(1)(b):
in O x 1�►;�; `
to 101.45 103.56 ; NOTE: A STRIPOUT OF UNSUITABLE SOILS 1) A 5' variance, S.A.S. to slab, for a 5' setback.
WILL BE REQUIRED AT BOTH ENDS
103,04 M o T 03,6 ;14�3.51 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
OF THE S.A.S. AND POTENTIALLY TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
103,28 x SHR. 10 4L:,' `'� T 1 WITHIN THE ENTIRE BOUNDARY. DESIGN ENGINEER.
' '..� v P� • •-.
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
z 5
(SEE NOTE 11) FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
vBREEZE GARAGE `� 00 ENGINEER BEFORE CONSTRUCTION CONTINUES.
3 iEXISG WAY slab M 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
TIN
slab o TP-2 0 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
W
103, 103.09 x
X HOUSE(#23) THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
104.3f U P HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
103.73 F 103,65 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
X 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S.
>- 103.50 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
103.79 Q AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
1 4.52 W
103.80 .::`ems DIRECTED BY THE APPROVING AUTHORITIES.
.. ., . .
TOP CTR.�STOOP �': ' 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
EL.=104.52 x X 3 Q:,;' :, THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
103.67 LOT 13 n WALK CONSTRUCTION.
10,100 fSF 1 1. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
j'.'' IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
103,7 x `L..;'. . REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
10 .00 x 103.46 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
O S 18'26 30" E INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL.
U,P• 103.38 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
103,62 :' NOT CONSIDERED TO BE A PROPERTY LINE SURVEY.
0
fence 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC
LA (?; ::; ;';:: <. X 102.55 SYSTEM COMPONENTS NOT SHOWN ON THE PLAN
\ - X PARCEL ID: 208-054
103.69 edge of pcvement 103.41
•tNOF� 103.00 102.53
ft-rN T.�G`� WILTONWA Y REVISED 5/17/17 PROPOSED SEPTIC SYSTEM UPGRADE PLAN
McE
SEPTIC PROFILE CORRECTION 32 WILTON DRIVE, CENTERVILLE, MA
CMIL
NO.35109 Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO.
CROCKER, WENDY Engineering Works, Inc. 1„=20' P.T.M. 170-17
32 WILTON WAY
�(_� � h CENTERVILLE, MA 02632 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET N0.
(508) 477-5313 5/6/17 P.T.M. 2 of 2
i
NOTE: TO PREVENT BREAKOUT, THE PROPOSED
f' FINISH GRADE SHALL NOT BE < EL:99.5
FOR A DISTANCE OF 15' AROUND THE
PROPOSED D-BOX PROPOSED S.A.S. PERIMETER OF THE S.A.S.
SEPTIC TANK INSTALL RISER AND COVER INSTALL RISER & COVER OVER ONE CHAMBER(MIN.)
INSTALL RISERS & COVERS OVER INLET & SET TO WITHIN 6" OF FINISH AND SET TO WITHIN 3" OF FINISH GRADE TO SERVE
OUTLET AND SET TO 6" OF FINISH GRADE GRADE
T.O.F.=104.3E AS AN INSPECTION MANHOLE.
EXISTING F.G. EL.=105.8(max.) r
F.G. EL.=103.5E F.G. EL.=103.7t 1
CV 0
' L = 54 L = 16'(MAX) Lf7
4 Q' ^0
S=1% (MIN.) ® S=1% (MIN.)
4'SCH40 PVC 4"SCH40 PVC IJS 11
s' ®�® 2" LAYER OF 1/8" SHR. A yj
1o"I 14„ s 12" WASH/ED DOUBLE
N 'SJ7
EXISTING 48" LIQUID (OR APPROVED FILTER FABRIC) GARAGE °' ��`
INV.=100.12t /BREEZE /
LEVEL (VERIFY) PROPOSED INV.=99.40 3WA
GAS BAFFLE 3.5 3' 3.5' /4"-1 1/2" TING/EXl$ slab slab
INV.=99.57 � INV.=99.00 EFFECTIVE WIDTH = 10' DOUBLE WASHED HOUSE(#23) T
H-10 RATED STONE
EXISTING SEPTIC TANK USE 5 LC-6 LEACHING CHAMBERS IN SERIES
T.O.F.=104.3E
WITH DOUBLE WASHED STONE-ALL SIDES
H-20 RATED
NOTES: TOP CONC. ELEV.=100.8
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE ®®®�®®® -BREAKOUT
INVERTS, PRIOR TO INSTALLATION. INV. ELEV.= 99.00 ELEV.=99.5
®®®®®®®
2) D-BOX SHALL BE SET LEVEL AND TRUE TO BOTTOM ELEV.= 98.00 I'mm
GRADE ON A MECHANICALLY COMPACTED SIX 3.5' 6' 3.5' S.A.S. LAYOUT
INCH CRUSHED STONE BASE, AS SPECIFIED IN 4' OF NATURALLY OCCURRING
310 CMR 15.221(2). PERVIOUS MATERIAL EFF. 'LENGTH-REFER TO SKETCH
3) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' (MIN.) ABOVE G.W. -- -----
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE LEACHING SYSTEM SECTION I 4• KNOCKOUT
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. NO G.W./BOTTOM OF TP, EL=91.8 = I 20• ow. COVER
I I
SEPTIC SYSTEM PROFILE (4•KNOCKOUT 4' KNOCKOUT
M
N.T.S. I I I
L------ 4• KNOCKOUT __U
28' SOIL LOG
r--------1 r 72•
o I BOTT. AREA I DATE: APRIL 20, 2017 (REF P#15,328) PLAN VIEW
r'L-- 370.0 SF i� SOIL EVALUATOR: PETER McENTEE PE, (SE#1542)
WITNESS: DONALD DESMARAIS R.S.
DESIGN CRITERIA 18 I I HEALTH AGENT ----
----
Ea
ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH ® ® E@ 22• ® ®
NUMBER OF BEDROOMS: 3 BEDROOMS 0�-; 0„ Ea ® ® Ea ® ® ® I I
SOIL TEXTURAL CLASS: CLASS I
1 0 103.4 103.3 IN 2Rr
DESIGN PERCOLATION RATE: <5 MIN/IN PERIMETERSIONS I I l I
SAS DIMENSIONS r- 72• � r• as' �
DAILY FLOW: 330 GPD FILL FILL SIDE VIEW END VIEW
DESIGN FLOW: 330 GPD SKETCH I
WIGGIN LC-6, H-20 LOADING
GARBAGE GRINDER: NO-AND NOT PERMITTED WITH THIS DESIGN 98.4 60" 98.4 59" LEACHING CHAMBER
EXISTING SEPTIC TANK: 1500 GALLON CAPACITY (ESTIMATED) C C L PERC
LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 54"/72"
.74 GPD/SF PROPOSED SEPTIC SYSTEM UPGRADE PLAN
USE 5 LC-6 LEACHING CHAMBERS IN SERIES SURROUNDED MED. SAND MED. SAND 2.5Y 6/6 2.5Y 6/6 32 WILTON DRIVE, CENTERVILLE, MA
WITH DOUBLE WASHED STONE-ALL SIDES AS SHOWN ON PLAN Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
SIDEWALL AREA: 94.0'(PERIMETER) x 1'(EFF. DEPTH) = 94.0 SF
BOTTOM AREA: 370.0 SF BOTTOM AREA ? Engineering by: SCALE DRAWN JOB. N0.
( ) = 370.0 SF Engineering Works, Inc. N.T.S. P.T.M. 170-17
TOTAL AREA:............................................ .............. 464.0 SF 91.9 138" 91.8 138" DATE
DESIGN FLOW PROVIDED: 0.74 GPD SF 464.0 SF = 343.4 GPD NO GROUNDWATER, PERC RATE: <2 MIN./IN. 12 West Crossfield Road, Forestdale, MA 02644 CHECKED SHEET N0.
/ ( ) (508) 477-5313 5/6/17 P.T.M. 2 Of 2
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